Provider Demographics
NPI:1932656659
Name:FAIEK, MINA MAHER (DMD)
Entity type:Individual
Prefix:
First Name:MINA
Middle Name:MAHER
Last Name:FAIEK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W MOANA LN STE 6
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4959
Mailing Address - Country:US
Mailing Address - Phone:757-583-7755
Mailing Address - Fax:
Practice Address - Street 1:601 W MOANA LN STE 6
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4959
Practice Address - Country:US
Practice Address - Phone:775-583-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-11
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000086122300000X
MADN18574301223G0001X
NV80491223S0112X, 1223X2210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery